ABSTRACT
@#Adenocarcinoma represents 0.5 to 2% of all malignant tumors of the bladder, and the mucinous subtype is extremely rare as a primary vesical lesion. The patient is a case of a 50-year-old male who initially presented with dysuria with occasional hematuria. A CT scan was done and showed bladder new growth. Cystoscopy Transurethral Resection of the bladder tumor was done revealing mucinous adenocarcinoma of the bladder. He then completed neoadjuvant chemotherapy with Pacitaxel and Cisplatin for 4 cycles, however repeat CT scan with contrast post chemotherapy showed progression of the adenocarcinoma. Due to the possibility of a primary lesion in the gastrointestinal tract, colonoscopy was performed revealing sessile serrated adenoma, as were tumor markers CA 19-9, CA 125, alpha-fetoprotein, and CEA, all of which without any abnormal results. He eventually underwent cystoprostatectomy and urethrectomy with extended bilateral pelvic lymph node dissection. The margins and lymph nodes were negative for tumor invasion. Adenocarcinoma is diagnosed mainly on histopathology and with the help of Immunohistochemistry (IHC). Once the diagnosis is confirmed, the radical surgery should be advised which could improve survival and disease progression.
ABSTRACT
A 60-year-old man presented with sudden-onset proptosis of the left eye and intermittent diplopia of 2 months duration. Ophthalmic examination revealed bilateral eyelid retraction, left eye proptosis and a firm, non-tender mass (2 cm × 1.5 cm) in left supero-medial orbit with restricted extraocular movements. Contrast-enhanced computed tomography showed a well-defined, enhancing antero-medial orbital mass which was removed via anterior orbitotomy approach. The histopathology/immunohistochemistry showed adenocarcinoma; metastasis of urothelial origin. The oncology consultation and metastatic workup revealed a urinary bladder carcinoma with distant metastasis. Our patient expired within 6 months of diagnosis. The ophthalmic symptoms due to orbital metastasis may be the first presentation of some cancer patients.